SHANA A GLIEM (NPI# 1831506948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831506948 |
| Entity Type | Individual |
| Full Name | SHANA A GLIEM |
| Credential | A.P.N. |
| Practice Address |
2710 Prosperity Ave Ste 200 Fairfax VA 22031-4358 |
| Practice Telephone | 7032802841 |
| Practice Fax Number | 7032804773 |
| Mailing Telephone | 7032802841 |
| Mailing Fax Number | 7032804773 |
| Enumeration Date | 2014-07-21 |
| Last Update Date | 2020-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024171876 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2710 PROSPERITY AVE STE 200 |
| City | FAIRFAX |
| State | VA |
| Zip Code | 22031-4358 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861579898 | Kimberly Ann Matzie | Surgery | 2710 Prosperity Ave, Suite 200, Fairfax, VA 22031-4357 | 2006-11-01 |
| 1518232685 | John David Tillou | Surgery | 2710 Prosperity Ave, Ste 200, Fairfax, VA 22031 | 2012-03-21 |
| 1164725982 | Elizabeth Klaes York | Physician Assistant | 2710 Prosperity Ave, Suite 200, Fairfax, VA 22031-4357 | 2010-12-16 |
| 1558536789 | Caroline Sanchez | Surgery | 2710 Prosperity Ave, Suite 200, Fairfax, VA 22031-4357 | 2008-04-29 |
| 1407079155 | Northern Virginia Eye Surgery Center, LLC | Clinic/Center | 2710 Prosperity Ave, Suite 150, Fairfax, VA 22031-4320 | 2007-04-11 |
| 1043356843 | Katherine Khalifeh | Surgery | 2710 Prosperity Ave, Suite 200, Fairfax, VA 22031-4357 | 2007-01-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902414105 | Su Jung Kang | Dentist | 9661-c Main Street, Fairfax, VA 22031 | 2020-07-14 |
| 1346896347 | Fuling Guo | Acupuncturist | 3013 James St, Fairfax, VA 22031 | 2019-08-15 |
| 1902458797 | Kayla Callister | Psychologist | 2270 Willow Oaks Corporate Drive, Fairfax, VA 22031 | 2019-07-11 |
| 1790349801 | Fairfax Dental Esthetics | Dentist | 9621 Fairfax Blvd., Fairfax, VA 22031 | 2019-04-24 |
| 1417427675 | Kathryn Yen Ho | Speech-Language Pathologist | 8270 Willow Oaks Corporate Drive Suite 2127, Falls Church, VA 22031 | 2018-11-30 |
| 1932681376 | Joanne Towers | Physician Assistant | 3025 Hamaker Court Suite 300, Fairfax, VA 22031 | 2018-09-01 |
| 1790262020 | S Renee Dennis | Nurse Practitioner | 8316 Arlington Blvd Ste 500, Fairfax, VA 22031 | 2018-07-19 |
| 1013493451 | Elizabeth Joan Dwyer | Physician Assistant | 3023 Hamaker Ct., Suite 500, Fairfax, VA 22031 | 2018-07-18 |
| 1316432669 | Delta Pharm LLC | Pharmacy | 8316 Arlington Blvd Ste 100, Fairfax, VA 22031 | 2018-06-28 |
| 1629567656 | Laura Breeden | Acupuncturist | 3846 Lyndhurst Dr Apt 301, Fairfax, Va, VA 22031 | 2018-05-04 |
| Find all providers in zip 22031 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376144147 | Emily Turner | Nurse Practitioner | 1099 Main St, Fairfax, VT 05454-9529 | 2020-11-06 |
| 1366041790 | Stephanie Ferber | Nurse Practitioner | 8081 Innovation Park Dr Fl 7, Fairfax, VA 22031-4867 | 2020-10-16 |
| 1578160198 | Northern Virginia Holistic Primary Care | Nurse Practitioner | 10304 Eaton Pl Ste 100, Fairfax, VA 22030-2238 | 2020-10-06 |
| 1821606377 | Lindsay Ann Bruno | Nurse Practitioner | 2921 District Ave Apt 504, Fairfax, VA 22031-2334 | 2020-07-21 |
| 1013534106 | Natalia Castro | Nurse Practitioner | 12817 Hamlet Hill Way, Fairfax, VA 22030-7250 | 2020-07-06 |
| 1629601448 | Lia Hoa Van | Nurse Practitioner | 3811 Glenbrook Rd, Fairfax, VA 22031-3105 | 2020-02-20 |
| 1043850175 | Olga Michelle Zaiter | Nurse Practitioner | 2740 Prosperity Ave Ste 100, Fairfax, VA 22031-4354 | 2020-01-07 |
| 1821650177 | Evelyne Kingori | Nurse Practitioner | 3022 Javier Rd Ste 105a, Fairfax, VA 22031-4646 | 2019-07-07 |
| 1770149726 | Laura E. Diaz | Nurse Practitioner | 3923 Old Lee Hwy Ste 61a, Fairfax, VA 22030-2428 | 2019-05-15 |
| 1295253102 | Mildred J Medrano | Nurse Practitioner | 9229 Arlington Arlington Blvd., Fairfax, VA 22031 | 2017-08-31 |
| Find all providers in FAIRFAX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.